We used 832 relevant publications from a thorough search across four databases to compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in the staging of bladder cancer (BCa). After reviewing 29 full-text publications, removing duplicates using Rayyan Qatar Computing Research Institute, and assessing relevance, we ultimately found eight research articles that met the inclusion criteria. We included eight studies with a total of 560 BCa patients, the majority of whom were males (73.2%). MRI demonstrated superiority over CT in low and intermediate tumor stages, particularly for assessing muscle-invasive BCa, which is critical for treatment planning. CT was more reliable for staging muscle-invasive BCa and localized disease, whereas MRI excelled in staging extravesical disease. Both modalities showed comparable accuracy in lymph node staging, with MRI's soft-tissue contrast offering an advantage in detecting subtle features. In addition, three studies found no significant differences between CT and MRI for primary tumor detection, highlighting their interchangeable use in specific contexts. This systematic review highlights the complementary roles of CT and MRI in BCa staging, with their use depending on the disease stage and clinical context. MRI is particularly effective for intermediate and advanced stages, especially in detecting muscle-invasive BCa, while CT remains valuable for localized and muscle-invasive disease. Both modalities perform similarly in identifying primary tumors and staging lymph nodes, enabling the customization of imaging strategies to meet the specific needs of each patient. Advanced imaging techniques, such as positron emission tomography/CT, offer potential improvements in diagnostic accuracy, particularly for nodal staging, and they can complement traditional methods. We need future prospective studies with standardized imaging protocols to further define the roles of CT and MRI, ensuring optimal diagnosis and patient outcomes.
Key words: Computed tomography, magnetic resonance imaging, bladder cancer, diagnostic accuracy, systematic review.
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